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High Risk Newborn

Review CH 27

What (5) factors present at birth that can place an infant at risk 1. Maternal low socioeconomic level 2. Exposure to environment dangers 3. Pre existing maternal conditions 4. Maternal Age and parity 5. Pregnancy complications
Maternal low socioeconomic level decreased access to health care
Exposure to environment dangers Toxic chemicals Illict drugs
Pre existing maternal conditions Heart disease diabetes hypertension Renal disease
Pregnancy complications Abruptio placentae Placenta previa Pre-eclampsia
What same factors (5) contribute to the common complications of the SGA (small for gest. age) newborn and the Pr AGA (preterm appropriate for gest. age) Newborn 1. Maternal factors 2. Maternal disease 3. Environmental factors 4. Placental factors 5. Fetal factors
Maternal factors contributing to common comp. of SGA and Pr AGA Grand multiparity Multiple gestation pregnancy Low socio economic status Poor maternal nutrition
Maternal disease contributing to common comp. of SGA and Pr AGA Heart disease Hypertension Pre-eclampsia
Environmental factors contributing to common comp. of SGA and Pr AGA Maternal use of drugs Exposure to toxins High altitude
Placental factors contributing to common comp. of SGA and Pr AGA Small placenta Placenta previa Abnormal cord insertions
Fetal factors contributing to common comp. of SGA and Pr AGA Congenital infections Chromosomal syndromes
Postmaturity Applies to any newborn born after 42 weeks gestation Most are of normal size and health
Post maturity syndrome Fetus is exposed to poor placental function, impairs nutrition and oxygenation,
Post maturity syndrome characteristics 1.Hypoglycemia 2.Meconium aspiration 3.Polycythemia 4.Congenital anomalies 5.seizure activity 6.Cold stress
Pre term newborn Respiratory difficulties 1. Lack of surfactant causes the alveoli to collapse, and the infant becomes hypoxic. 2. Incomplete development of the muscular coat of the pulm. blood vessels, leads to left- to- right shunting of blood through the ductus arteriosus back into lungs.
Pre term newborn Temperature control difficulties 1. Less able to produce heat b/c of the higher ratio of body surface to body weight. 2. Lack of brown fat 3. Thin skin, causes greater insensible water loss 4. Lack of flexion increases heat loss
Pre term newborn Gastrointestinal difficulties 1. Poor suck effort 2. High caloric needs & limited ability to take in nutrition 3. Increased basal met. rate & O2 needs related to increased effort at sucking 4. Increased chance of aspiration
Pre term newborn Gastrointestinal difficulties continued 5. Decreased ability to convert amino acids 6.Decreased ability to handle formula protein 7. Diminished blood flow to the intestines, resulting in necrotizing enterocolitis
Nursing assessment and initial interventions for newborn w/ selected congenital anomalies focus on 1. Respiratory 2. Nutritional 3. Neurologic 4. Parental involvement
Respiratory focus for newborn with selected congenital anomalies 1. Ability of infant to breathe 2. Maintain Respiratory function
Nutritional focus for newborns with selected congenital anomalies 1. Is infant able to suck and swallow 2. Does feeding cause Respiratory distress? 3.Intervention: Provide calories by breast, nipple, gastro tube, or IV
Neurologic focus for newborns with selected congenital anomalies 1. Is infant able to move all extremities? 2. Is head circumference normal size, and maintain normal size? 3. Intervention: Keep HOB elevated if head circumference is larger than normal
Parental involvement for newborns with selected congenital anomalies 1. Assess parents knowledge of infants anomaly 2. Keep parents informed about infants condition 3. Teach parents appropriate home care of infant
Special care of the infant who was exposed to drugs or alcohol focuses on 1. Assessment of the mothers last drug intake and dosage 2. Assessment for congenital anomalies and complications 3. Assess feeding difficulties 4. Provide low stimulus environment to minimized withdrawal complications
Created by: Jaycee420